OrganizationTemple Faculty Practice Plan IncFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address9433 Roosevelt Boulevard, Philadelphia, PA 19114(215) 707-2400(215) 926-9019PECOS EnrollmentBased on the most recent information from CMS, provider Temple Faculty Practice Plan Inc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1255024212Provider TypeOrganizationFull NameTemple Faculty Practice Plan IncSubpartYesEnumeration Date5/26/2023Last Updated5/26/2023Contact InformationPractice LocationPractice Address9433 Roosevelt Boulevard, Philadelphia, PA 19114Phone(215) 707-2400Fax(215) 707-4034Mailing LocationMailing Address3500 N Broad St Rm 1a, Philadelphia, PA 19140-4106Phone(215) 926-9019FaxUnlisted FaxAuthorized OfficialNameVaughn, Richard (Credentialing Specialist)Phone(215) 926-9019Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted Issuer